Official ESCRS | European Society of Cataract & Refractive Surgeons

Deep sclerectomy versus combined trabeculectomy trabeculotomy in congenital glaucoma: A randomized clinical trial

Session Details

Session Title: Special Cases
Session Date/Time: Friday 20/02/2015 | 08:30-10:30
Paper Time: 08:58
Venue: Sadirvan B
First Author: : S.Al-Obeidan SAUDI ARABIA
Co Author(s): :                  

Abstract Details


To compare the efficacy and safety of deep sclerectomy to combined trabeculectomy trabeculotomy in congenital glaucoma.


A randomized clinical trial at King Abdulaziz university hospital, Riyadh, Saudi Arabia


A consecutive number of newborn children with congenital glaucoma were recruited in this study. Surgical procedure was randomly allocated to the first operated eye of each child. Pre and post intervention glaucoma indices were assessed including; intraocular pressure, cup/disc ratio, corneal diameter, corneal thickness, number of anti-glaucoma medications, and degree corneal haze. Complete success was identified as achieving post operative IOP <21 without any anti-glaucoma medication.


Seventy eyes of 35 patients were recruited in this study with 35 eyes in each arm. Intraocular pressure, number of medications and corneal haze significantly reduced in each arm. However, this difference was not statistically significant across both study arms (p = 0.723, 0.729, 0.998, and 0.692 respectively). However, the overall rate of complications (52.6%) was significantly higher in the combined arm than in the deep sclerectomy arm (5.7%; p < 0.001). Meanwhile, the complete success rate was 68.6% in the deep sclerectomy arm and 57.1% in the combined arm where such difference didn't reach the statistical significance level.


Although the combined trabeculectomy trabeculotomy procedure has excellent impact on IOP reduction, it yields a number of serious sight threatening post operative complications. Deep sclerectomy procedure may give higher reduction in IOP; however, such reduction insignificantly differs from the combined procedure. Nevertheless, deep sclerectomy is much safer in terms of its lower rate of visually threatening complications.

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